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Alaska rates for HCPCS B4152

Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $1.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.24 / $0.24
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.49 / $0.49 / $2.39
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.55 / $1.87
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.37 / $0.56 / $0.56
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.49 / $0.49 / $2.39
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.40 / $0.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.84 / $0.94 / $1.41